The art is replete with clips for use in surgical procedures. Examples of surgical clips are shown in U.S. Pat. Nos. 4,434,795, 4,476,865, 4,616,651, 4,620,541, 4,671,281, 4,556,060, 5,062,846, and 5,026,379.
Some surgical clips have a biasing means for biasing the clip toward a clamped configuration. Examples of such clips are found in U.S. Pat. No.'s 3,996,937, 4,024,868, 4,444,187, 4,658,822, 4,660,558, 4,777,950, and 5,053,045. However, such clips are generally not used in every application.
A typical malleable surgical clip is shown, for example, in U.S. Pat. No. 3,713,533. That clip is initially provided in an unclamped position. The clip includes a pair of legs that are plastically deformable by a clip applier tool from the initial, unclamped position to a clamped position.
Other malleable, plastically deformable surgical clips are shown, for example, in U.S. Pat. Nos. 4,449,530, 4,702,247, 4,799,481, 4,844,066, 4,976,722, 4,979,950 and 5,026,382. Examples of clip applier tools are shown in U.S. Pat. Nos. 3,856,016, 3,954,108, 4,242,902, 4,299,224, 5,084,057 and 5,100,420 the entire contents of which are herein expressly incorporated by reference.
Surgical clips such as those shown in U.S. Pat. No. 3,713,533 tend to have difficulty in occluding tubular anatomical structures during some applications. In those applications, such clips tend to slip or slide off the tubular structure either intra-operatively or post-operatively with undesirable results for the patient.
The tendency for prior art clips to slide or slip off a tubular structure is particularly a problem when the single legged clips are used in a procedure where the tubular structure is both clipped and cut. FIG. 16 illustrates an anatomical tubular structure 201 (such as a vessel) which is "divided" or cut at end 202. Typically, a surgeon may use two, individual prior art clips 203 and 204 to clip the structure 201. Because clip 204 is in close proximity to cut end 202, there is a chance that the clip 204 may separate from the tubular structure 201 resulting in undesirable consequences for the patient.
While in some instances surgical clips may be left permanently within the patients' body, in some surgical procedures, the surgical clips are removed from the tubular structure (e.g. a vessel) before the surgical procedure is completed. A general purpose tool generally known as the "Grasper" generally available from Karl Storz, Germany is used to remove a surgical clip. An example of such a clip removal tool is shown in FIG. 15.
U.S. Pat. Nos. 3,856,016 and 3,954,108 disclose a single surgical clip which is said to constitute in effect two occlusion clips for use in, for example, occluding fallopian tubes. When such clips are used to occlude fallopian tubes they are generally intended to remain on the fallopian tubes permanently. Moreover, it is believed that such clips would be difficult to safely remove from the tubular structure. To remove such a clip from the tubular structure, typically the surgeon would either (1) grasp only one leg which results in an asymmetric removal force which may damage tissue, or (2) grasp both legs simultaneously which may be difficult to accomplish due to the lack of structure at the hinge portion between the legs and due to the potential for the hinge to collapse (also as a result of the lack of structure at the hinge portion).